From left: Frederick Reed, Fort Hood Emergency Medical Services chief; Dawn O’Connell, Carl R. Darnall Army Medical Center triage and charge nurse; Lt. Col. (Dr.) James Lucas, Carl R. Darnell chief of the Department of Surgery; and Maj. (Dr.) Michael Simpson, Carl R. Darnell ER officer-in-charge, stand next to the emergency bay in which ambulances delivered the casualties from the April 2 shooting on Fort Hood. All four pictured here and their teams treated every casualty hurt in the incident, in many cases saving lives with only minutes to spare. Four people were killed and 16 injured in the tragedy. (U.S. Army photo by Sgt. Ken Scar, 7th Mobile Public Affairs Detachment)

FORT HOOD, Texas - Evil reared its ugly head on Fort Hood again April 2, and once again the everyday heroes of the Great Place rose up to meet it head-on. At the tip of that spear, as always, were the emergency responders who charged into the disorder and confusion to save lives.

Dawn O’Connell, the emergency room triage and charge nurse at the Carl R. Darnall Army Medical Center, said she heard the mass casualty alarms go off throughout the hospital and thought it was a drill, until the casualties started coming in.

“We practice for incidents like this all the time,” she said. “I said, ‘not today, not today.’”

She knew it was not an exercise when a group of Fort Hood emergency medical technicians burst into the emergency room ahead of the first wave of casualties.

“Within one minute, a car came in and dropped the first victim off. We had maybe three minutes to get ready for the rest ... and we were ready.”

With three killed and more than 10 wounded from the gunshots, the injured were coming in one after the other, and the staff of CRDAMC was ready for them.

Meanwhile, Fort Hood Emergency Medical Services teams were driving ambulances right into the middle of a developing active shooter situation to rescue the wounded.

For several hours, it was unknown if the shooter was still at large, or if there was more than one.

Frederick Reed, the Fort Hood Emergency Medical Services chief, said that six ambulances rushed to the scene carrying teams of two or three medical technicians, every one of them a veteran of the Nov. 5, 2009, shootings that left 13 dead and 32 wounded.

“The lessons learned from (2009) absolutely helped the response to this incident,” he said, pointing out that, unlike their comrades in nearby cities like Austin, San Antonio and Dallas, the emergency medical technicians at Fort Hood are not issued body armor. None of them hesitated to rush in unprotected to rescue Soldiers.

Outside the gates of the installation, CRDAMC Emergency Department officer-in-charge Maj. (Dr.) Michael Simpson and many of his staff had finished work for the day.

“I was on my way home, in Florence getting gas. My staff called and texted me immediately and told me exactly what was going on. I sent out a brief text saying, everybody get back – but be careful.”

Like the EMTs, Simpson and his staff rushed into harm’s way before the shelter in place order had been lifted.

“I want to publicly commend all of my staff, because everybody knew it was an active shooter scenario, and they all came charging through the gate and reported to their place of duty without a thought of personal safety, with no worries of if they had the shooter contained. I’ve been wearing a uniform for 30 years, and for me that was really inspiring to see.”

Lt. Col. (Dr.) James Lucas, the CRDAMC chief of the Department of Surgery, said he wasn’t sure what to think at first.

“At first you’re just thinking, is this real?” he said. “I’ve seen plenty of trauma, but I’ve never been involved in a mass casualty like this, other than drills. The response by everyone was extremely impressive. One of my surgeons almost got into a confrontation with a gate guard trying to get (back onto the post). He showed every credential he had and was eventually able to get in.”

Lucas said the victims had various degrees of wounds; from cuts, scrapes, punctures and mild concussions, to severe gunshot wounds.

“Every single person wounded in this incident came through this hospital,” Simpson said. “As the patients came in, we had to make joint determinations of which person was in the most grave danger, which had to stay here so we could save their life. Credit goes to Col. Lucas’s surgical staff – they absolutely saved the most critically wounded patients and made sure they were stabilized before getting sent to Scott & White.” (Baylor Scott & White Memorial Hospital in nearby Temple is a level 1 trauma center, better equipped to tend some of the most serious wounds than CRDAMC, which is a level 3.)

The two men described a frantic scene of organized chaos as doctors and nurses efficiently treated the arriving wounded, leaving no doubt that as many as eight critically wounded patients owe their lives to Fort Hood’s emergency responders that day.

“One of the neck injuries, specifically, had he not arrived here when he did he probably had another ten minutes to live,” Lucas said.

Lucas also made a point to single out the CRDAMC cleaning crew, who jumped into action alongside everyone else.

“They probably didn’t really sign up for this type of event,” he said. “These housekeepers were in there just doing an amazing job. The minute we wheeled one patient out, they were in there cleaning blood off the floor as fast as they could, ready to receive the next patient. They weren’t just sitting there in shock – they seized the moment and did their thing. I was extremely impressed.”

Not surprisingly, even more stories of heroism began to emerge from the injured that were able to talk as they were treated and stabilized.

“I saw some wounds that I would say were suffered rather heroically, getting other people out of the way,” Simpson said. “There were people who injured themselves saving others, and then went back for more.”

All 16 survivors of the shooting rampage are expected to live. That one statistic says it all about Fort Hood’s medical professionals.